A study on the predictive factors of intestinal necrosis in acute mesenteric ischemia / 中华普通外科杂志

ABSTRACT

Objective:To explore the predictive factors of intestinal necrosis in acute mesenteric ischemia.Methods:This retrospective study enrolled 81 patients diagnosed as acute mesenteric vascular occlusive diseases in Zhongshan Hospital, Fudan University between Nov 2012 to May 2017. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis.Results:In univariate analysis, the predictive factors of intestinal necrosis were peritoneal irritation sign ( P<0.001), white blood cell count ( P<0.001), serum albumin ( P=0.028), blood creatinine ( P=0.025), serum lactic acid ( P=0.008), D-dimer ( P=0.037), intestinal pneumatosis ( P=0.017), decreased or disappeared enhanced bowel wall ( P<0.001) and bowel loop dilation>2.5 cm ( P=0.01) on CT scan. According to multivariate logistic regression analysis, white blood cells ( OR=3.60, 95% CI 1.51-5.47, P=0.007), lactic acid ( OR=4.80, 95% CI 1.36-9.89, P=0.032), reduced or disappeared enhanced bowel wall ( OR=10.57, 95% CI 1.82-61.10, P=0.008) were independent predictive factors of intestinal necrosis in patients with acute mesenteric ischemia. Conclusions:The predicted risk factors for intestinal necrosis in mesenteric ischemic diseases are increased white blood cells, elevated serum lactate levels, and reduced or disappeared enhanced bowel wall on CT scan.